Pre-procedure Assessment Center (P-PAC)

Our purpose is to ensure you are in your optimal physical and psychological health on the scheduled day of your surgery or outpatient procedure.

What you can expect

The average Pre-procedure Assessment Center visit varies from 30 minutes to 1 hour. During your P-PAC interview with one of our registered nurses, you can expect to be asked a variety of questions concerning your medical history, your current medical condition, your physical condition, your surgical history, your current medications list and your allergies. This interview may take place via telephone or may require a visit to the P-PAC at The Villages® Regional Hospital's East Campus. If not already done elsewhere, you can also expect the nursing staff and our technicians to carry out your physician's, surgeon's and/or anesthesiologist's orders for tests, to include labs, EKG and radiology. We also take time to educate you and/or your significant other about the planned surgery/procedure, hospital routines and protocols, length of stay, and approximate procedure times. Afterward, your nurse will assemble a chart with all of your personal information and forward it to the appropriate hospital department in anticipation of your surgery/procedure.

See the medication list and surgical history documents below. They can be printed and filled out to help you prepare for your telephone screening or live visit with the P-PAC nurse. They can also be brought with you on the day of surgery, as your pre-op nurse and/or anesthesia provider will ask you to confirm this information.

Pre-op cleansing instructions

What to bring the day of your surgery/procedure

Bring a current list of your home medicines and vitamins with you, indicating the last date/time you took them. Please use our printable medication list.

Because you will have anesthesia/sedation, you will not be able to drive yourself home. You will need a responsible adult driver to take you home after your surgery/procedure.

If you wear glasses, please bring an eyeglass case. Do not wear contacts on the day of your surgery/procedure.

If you wear dentures and/or hearing aids, please bring a container for them.

A parent or legal guardian must accompany a minor.

For the safety of your loved ones, do not bring children with you. There are no facilities or personnel to provide supervision.

Bring your polar care (cold pack) with you as advised by your surgeon.

Sleep apnea: If you are a surgical patient and you have sleep apnea, bring your CPAP/BiPAP machine with you the day of surgery, along with distilled water.

Personal items will be given to your family member just prior to surgery. Therefore, it is important that your family member be available before you go to surgery.

Diet/food

Do not smoke, eat or drink anything after midnight prior to your surgery. No gum, no mints and no water. If you do not follow these instructions, your surgery may be delayed or canceled.

If you are scheduled for an afternoon surgery, it is important that you do not eat or drink anything after midnight. Sometimes surgeries get canceled the morning of, and this could result in your surgery being earlier. If this happens, we will contact you to come in earlier.

You may brush your teeth and spit it out the morning of your surgery.

Medications/over-the-counter medications

Do not bring your home medicines to the hospital with you. For your safety, we will dispense medicine to you. Bring a current list of all medications, including vitamins, with you.

Take only your prescription medications, especially your heart and blood pressure medication, as instructed by your surgeon/physician with a sip of water prior to leaving home (with the exceptions listed below).

Diabetic pills and insulin: Do not take your diabetic medications the morning of your procedure.

If you are on insulin: Take your normal dose the night before surgery.

If you use an insulin pump, keep it on during the night and stop it when you get up in the morning.

Do not take over-the-counter drugs/medications the morning of your surgery.

If you are taking any blood thinners and/or any of the medications listed below and your surgeon has not told you to stop these medications, call him or her immediately and discuss this.

Aspirin, fish oil, omega 3, vitamin E, ginseng and ginkgo.

Aspirin with dipyridamole (Aggrenox).

Apixaban (Eliquis).

Cilostazol (Pletal).

Dabigatran (Pradaxa).

Dipyridamole (Persantine).

Fondaparinux (Arintra).

Prasugrel (Effient).

Plavix (Clopidogrel).

Rivaroxaban (Xarelto).

Ticagrelor (Brilinta).

Warfarin (Coumadin, Jantoven).

Jewelry and other valuables

Do not bring any valuables with you, with the exception of cash and/or a credit card for your payment the day of surgery.

Do not bring any jewelry with you. All jewelry must be removed prior to the day of surgery, or your surgery could be canceled; this includes wedding bands, watches, earrings, necklaces, bracelets and ankle bracelets.

All body piercing jewelry must be removed.

Your safety is our top priority. For your safety, these items are removed because IV fluids are given during the procedure, and this could result in swelling, which could lead to circulation being reduced in your extremities. We also use a cauterizing tool in many procedures that stops blood vessels from bleeding. This tool needs to be grounded, and if any metal is left on the body, it could arc to that metal, causing a burn.

Clothing

Wear loose, comfortable (appropriate) clothing that can be easily folded and placed in a bag. These items will be labeled with your name and returned to you prior to discharge.

Personal hygiene

A complete bath or shower (shower preferred if possible) should be taken with antimicrobial soap (e.g., Dial soap) prior to surgery. Please pay special attention to clean extremely well the area of your surgery.

If you are having foot surgery, remove toenail polish on the operative foot.

For your safety, do not wear any makeup, lotions, creams or fragrance on the day of your surgery/procedure.

Illness

Notify your surgeon of any changes in your physical condition prior to your procedure (e.g., flu, cold, contagious disease, skin tears and infected wounds). This will most likely postpone your surgery. For your safety, anesthesia will not be used to put you to sleep if you are sick, as this could affect your recovery.

On the day of your surgery or procedure

Report to the Express Check-In on the day and time of your surgery/procedure. The clerk will verify your information and place an armband on you.

Do not remove this armband; it is used to identify you throughout your hospital stay. For your safety, everyone will be asking you your name, date of birth and what surgery/procedure you will be having.

You will be escorted to the pre-op area or a surgical waiting room. Once in the pre-op area, the nurse will have you change into a hospital gown.

All clothing must be removed. This includes bras and underwear. This is for your safety.

You will then be asked to get into the bed and will be hooked up to the monitor. We will monitor your heart rate, blood pressure, respiratory rate and oxygen saturation.

The nurse will start an IV prior to your procedure. This is to provide fluids/medications. IVs are started in the hand, so when you are in the operating room the anesthesiologist can monitor the IV to be sure you are receiving all the medication. Instruct the nurse if you have any pain, tenderness or swelling at the IV site.

Oxygen will be administered in the operating/procedure room and in the recovery room.

Pain medication will be available. Your comfort and pain level will be assessed continuously.

Your family can stay with you up until the point when we take you to surgery. Visitors are limited to 2 at a time to ensure privacy and confidentiality of other patients.

When we take you back for surgery, we will have your family wait in the surgical waiting room. Our waiting rooms can be cold, so let them know to bring a sweater or a jacket.

The operating room nurse will update your family during the operation.

After the surgery, the surgeon will visit or call your family with an update on your status.

When you are out of surgery, you will go to the recovery room. You will be there until you are ready for discharge/transfer to the floor.

If you are going home, we will call your family and arrange for them to pick you up at the discharge door.

If you are being admitted to the hospital, a room will be assigned while you are in the recovery room. We will notify your family of your room number and the estimated time you will be transported to that room.

You may be admitted to the hospital if your condition warrants.

The recovery room nurse will update your family throughout the entire recovery process.

Family may or may not be allowed to visit you in the recovery room, based on privacy and confidentiality of other patients.

You may be required to tolerate fluids prior to discharge (this may not apply to all patients). You may be required to urinate prior to discharge (this may not apply to all patients).

Your care at home

Do not drive or operate any machinery for 24 hours after your surgery/procedure.

Do not consume alcohol, tranquilizers or any nonprescribed medication for 24 hours.

Do not make important decisions or sign any important papers for 24 hours after your surgery/procedure.

You should have someone available for any emergency situations that may arise.

You are advised to go directly home from the hospital. Restrict your activities, resting for a day. Resume light to normal activity the day after your surgery, as instructed by your surgeon.

Additional discharge instructions will be given to you the day of your surgery.

During the interview with your Pre-Procedure Assessment Center Nurse you will be given an opportunity to discuss any questions or concerns you may have. You will also be given their phone number in case additional questions or concerns arise.